Decisions

When you're second on at night you can go over to the intern house and sleep; they will page you when you are needed. The only problem is that when they page you you are needed immediately and if you are not there in one minute they will page you again. If you can, sleep in your scrubs and have your stuff ready to grab as you run out the door.

They code for second on when the client starts second stage. You will get used to breathing stinky morning breath on clients and fellow interns, I promise. When you are second on you're (usually) not needed for very long... about one to two hours. You chart the second stage, take FHTs, keep the time of birth, cord cut, and placenta, hand the instruments, and call for Apgars - kind of basic early apprenticeship type stuff. After the placenta is delivered you get the midwife a bowl of betadine water (oh, and as a special treat each midwife likes their water a different strength so you will have to learn who likes what) then clean and restock the birth bowl. If you're feeling generous you can clean the instruments but that is technically the role of first on. I always ask the midwife and the first on if there is anything else I can do and then I'm off... either to sleep or to run citas like a mad woman.

Today four births occurred directly before prenatals and it was absolutely hellish running citas non-stop without breakfast, coffee, water, or even a pee break. I did 4 registrations with the LM... Which reminds me: Those of you doing the PEP and attempting to avoid the QE skills exam need to be sure of who signs your paperwork! One of the midwives is an LM and not a CPM so if she signs anything you can no longer do the secondary assessment of skills and avoid the skills exam.

Also, you will observe a lot of births (they code almost all of the births for everyone to come and observe) and these count for nothing other than you got to watch a birth. I know, I'm jaded after having been in this for 7 years but I no longer want to get out of bed at 3:00am to just stand and watch a birth... also, sometimes it feels voyeuristic to stand with 3 or 4 other interns at the foot of this woman's birth bed and stare at her crotch. But, you still get to see cool stuff so it is worth trying to make it to as many observes as you can. I don't even know how many births I have been to in 2.5 weeks... at least 15.